Healthcare Provider Details

I. General information

NPI: 1124012414
Provider Name (Legal Business Name): ROBERT L MICHAELS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

986 SUNRISE HWY
WEST BABYLON NY
11704-6111
US

IV. Provider business mailing address

990 STEWART AVE SUITE 400
GARDEN CITY NY
11530-4822
US

V. Phone/Fax

Practice location:
  • Phone: 631-587-6060
  • Fax: 631-587-1364
Mailing address:
  • Phone: 516-222-2022
  • Fax: 516-222-8475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number207081
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: